基于互联网和面对面的认知行为疗法对强迫症的比较:系统性审查和网络元分析
Wenxuan Zhang1, Weili Yang2, Hanyang Ruan1
1Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
Journal of psychiatric research
|October 31, 2023
概括
认知行为疗法 (CBT) 对强迫症 (OCD) 有效. 基于互联网的CBT (ICBT) 是有前途的,当传统CBT无法使用时,建议使用治疗师指导的ICBT.
科学领域:
- 精神病学是一个精神病学.
- 心理健康 心理健康
- 行为科学 行为科学
背景情况:
- 认知行为疗法 (CBT) 是强迫症 (OCD) 的领先治疗方法.
- 对于许多患者来说,获得传统的CBT是有限的.
- 基于互联网的CBT (ICBT) 为改善可访问性提供了一个潜在的解决方案.
研究的目的:
- 为了比较各种CBT格式对强迫症的疗效.
- 评估治疗师指导的ICBT (TG-ICBT) 和非指导的ICBT (UG-ICBT) 与传统的CBT.
- 评估二次结果,包括抑郁症状,副作用和成本效益.
主要方法:
- 一个25项试验的网络元分析,涉及1642名参与者.
- 主要结局:使用耶鲁-布朗强迫症强迫症度表 (Y-BOCS) 或儿童耶鲁-布朗强迫症强迫症度表 (CY-BOCS) 的强迫症严重程度变化.
- 二次结果:抑郁症状,副作用,成本效益.
主要成果:
- 与TG-ICBT相比,CBT显示出更高的疗效.
- 虽然在统计学上不显著,但CBT显示出比UG-ICBT更大的改善.
- 所有ICBT格式 (TG-ICBT,UG-ICBT) 都比安慰剂或等待列表更有效.
- 结合药物的CBT比单独的CBT或ICBT形式更有效.
结论:
- 当传统的CBT无法获得时,建议使用治疗师指导的ICBT.
- 非指导性ICBT为CBT提供了一个潜在的替代方案,需要进一步研究.
- 结合CBT和药物治疗为强迫症治疗提供了最高的疗效.
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